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Author: Brian S McGowan, PhD

ABSTRACT: Imaging-based observational databases for clinical problem solving: the role of informatics

Imaging has become a prevalent tool in the diagnosis and treatment of many diseases, providing a unique in vivo, multi-scale view of anatomic and physiologic processes. With the increased use of imaging and its progressive technical advances, the role of imaging informatics is now evolving—from one of managing images, to one of integrating the full scope of clinical information needed to contextualize and link observations across phenotypic and genotypic scales. Several challenges exist for imaging informatics, including the need for methods to transform clinical imaging studies and associated data into structured information that can be organized and analyzed. We examine some of these challenges in establishing imaging-based observational databases that can support the creation of comprehensive disease models. The development of these databases and ensuing models can aid in medical decision making and knowledge discovery and ultimately, transform the use of imaging to support individually-tailored patient care.

via Imaging-based observational databases for clinical problem solving: the role of informatics — Bui et al. — Journal of the American Medical Informatics Association.

ABSTRACT: E-learning: the essential usability perspective

BACKGROUND:
Usability is the ease with which something can be used, but this essential concept appears to be rarely considered when using technology for teaching and learning in medical education.
CONTEXT:
There is an increasing use of technology in an attempt to enhance teaching and learning in medical education, from the use of websites and virtual learning environments (VLEs) to interactive online tutorials to blogs and podcasts. However, research suggests that the potential use of technology to enhance teaching and learning in medical education is often not fully realised. One aspect is the perceived usefulness of the technology, but another is the usability as perceived by the learner.
INNOVATION:
The purpose of this article is to introduce the concept of usability in relation to the use of technology to enhance teaching and learning in medical education, the essential factors that should be considered in the design and implementation of using technology, and to describe how the usability can be tested.
IMPLICATIONS:
Careful attention needs to be made to the main factors that determine usability: the learner and context; the technology being used; and the content.

via E-learning: the essential usability perspective. [Clin Teach. 2013] – PubMed – NCBI.

RESOURCE: Five medical apps that keep your medical knowledge current

Traditional methods of staying up to date with medical knowledge include structured activities like attending conferences and unstructured activities like reading journals–both of which involve the unidirectional transfer of knowledge.As medical schools shift to more collaborative models of training where students are encouraged to discuss and challenge what they are taught, one would expect that this type of learning may not be ideal for future generations of clinicians.Fortunately, we are now seeing the emergence of tools that will help add a new dimension to continuing education; one where even a rural primary care physician can participate in thoughtful debate about the latest hypertension guidelines with far flung peers.

via Five medical apps that keep your medical knowledge current.

ABSTRACT: Too Close or Too Far Hurts: Cognitive Distance and Group Cognitive Synergy

Groups encounter difficulties in becoming better than their individual members. This study assesses the nature of the relationship between cognitive distance (operationalized as the extent to which the best performing individual is detached from the rest of the group) and two types of group synergy: weak cognitive synergy (collective performance is better than average individual performance) and strong cognitive synergy (collective performance exceeds the performance of the best individual in the group). We hypothesized that the relationship between cognitive distance and group cognitive synergy has an inverted U shape and we test this curvilinear relationship in two studies using judgmental and decision-making tasks. The first study shows that cognitive distance is beneficial for both weak and strong group cognitive synergy up to a point and then it becomes detrimental. A second study replicates the findings only for weak and not for strong synergy in a task that evaluates individual and collective rationality in decision making.

via Too Close or Too Far Hurts: Cognitive Distance and Group Cognitive Synergy.

ABSTRACT: Social Constructivist Teaching Strategies in the Small Group Classroom

The purpose of this article is to describe a series of techniques for teaching students about groups. Vygotsky’s social constructivism is used as a theoretical framework to understand the ways that students acquire knowledge about groups. After a brief discussion of this framework, we turn to a discussion of five specific pedagogical techniques for teaching small group and teamwork principles. These techniques include (a) carefully assigning group membership, (b) using a grading structure that incorporates individual, group, and peer evaluation assessment, (c) testing students individually and in groups, (d) asking students to write two papers that require an analysis and synthesis of both readings and observations, and (e) requiring a comprehensive service learning project from students that requires their collaboration for successful completion. The last portion of the article describes the challenges of using each of these techniques and the typical results of their application

via Social Constructivist Teaching Strategies in the Small Group Classroom.

ABSTRACT: Reducing Faultlines in Geographically Dispersed Teams: Self-Disclosure and Task Elaboration

Faultlines have the potential to significantly disrupt team performance due to the creation of intergroup bias. In geographically dispersed teams, given the combination of dispersed locations and other diversity characteristics, faultlines are potentially a major issue that needs to be more fully understood. This study examines the impact of faultlines on geographically dispersed teams and how problems caused by faultlines can be resolved. An experimental study of 40, four-person student teams finds that perceived faultlines heighten conflict and impair decision process quality. The findings also suggest that self-disclosure via weblogs and task elaboration can repair damage caused by faultlines. However, self-disclosure does not have a direct effect on reducing faultlines; the relationship is moderated by social attraction. That is, as team members disclose personal information to out-group members and out-group members are attracted to such disclosure, perceived faultlines are diminished. This study also finds that even in teams with strong perceived faultlines, team members are still able to exchange and integrate perspectives if they have a better understanding of their out-group members via self-disclosure. The negative consequence of faultlines therefore is eased when task elaboration occurs during task execution. Implications of these coping mechanisms for teams with faultlines in organizations are discussed.

via Reducing Faultlines in Geographically Dispersed Teams: Self-Disclosure and Task Elaboration.

RESOURCE: A Visual Guide To Every Single Learning Theory

This concept map is elaborate and downright incredible. Robert Millwood built this behemoth and you should be sure to head over to his site to thank him and learn more about the Holistic Approach to Technology Enhanced Learning HoTEL. In any case, this detailed analysis and chart of every single learning theory is worth zooming in and studying.

via A Visual Guide To Every Single Learning Theory | Edudemic.

ABSTRACT: Top five flashpoints in the assessment of teaching effectiveness

BACKGROUND:
Despite thousands of publications over the past 90 years on the assessment of teaching effectiveness, there is still confusion, misunderstanding, and hand-to-hand combat on several topics that seem to pop up over and over again on listservs, blogs, articles, books, and medical education/teaching conference programs. If you are measuring teaching performance in face-to-face, blended/hybrid, or online courses, then you are probably struggling with one or more of these topics or flashpoints.
AIM:
To decrease the popping and struggling by providing a state-of-the-art update of research and practices and a “consumer’s guide to trouble-shooting these flashpoints.”
METHODS:
Five flashpoints are defined, the salient issues and research described, and, finally, specific, concrete recommendations for moving forward are proffered. Those flashpoints are: (1) student ratings vs. multiple sources of evidence; (2) sources of evidence vs. decisions: which come first?’ (3) quality of “home-grown” rating scales vs. commercially-developed scales; (4) paper-and-pencil vs. online scale administration; and (5) standardized vs. unstandardized online scale administrations. The first three relate to the sources of evidence chosen and the last two pertain to online administration issues.
RESULTS:
Many medical schools/colleges and higher education in general fall far short of their potential and the available technology to comprehensively assess teaching effectiveness. Specific recommendations were given to improve the quality and variety of the sources of evidence used for formative and summative decisions and their administration procedures.
CONCLUSIONS:
Multiple sources of evidence collected through online administration, when possible, can furnish a solid foundation from which to infer teaching effectiveness and contribute to fair and equitable decisions about faculty contract renewal, merit pay, and promotion and tenure.

via Top five flashpoints in the assessment of teaching… [Med Teach. 2013] – PubMed – NCBI.

ABSTRACT: Looking back to move forward: using history, discourse and text in medical education research

As medical education research continues to diversify methodologically and theoretically, medical education researchers have been increasingly willing to challenge taken-for-granted assumptions about the form, content and function of medical education. In this AMEE guide we describe historical, discourse and text analysis approaches that can help researchers and educators question the inevitability of things that are currently seen as ‘natural’. Why is such questioning important? By articulating our assumptions and interrogating the ‘naturalness’ of the status quo, one can then begin to ask why things are the way they are. Researchers can, for example, ask whether the models of medical education organization and delivery that currently seem ‘natural’ to them have been developed in order to provide the most benefit to students or patients–or whether they have, rather, been developed in ways that provide power to faculty members, medical schools or the medical profession as a whole. An understanding of the interplay of practices and power is a valuable tool for opening up the field to new possibilities for better medical education. The recognition that our current models, rather than being ‘natural’, were created in particular historical contexts for any number of contingent reasons leads inexorably to the possibility of change. For if our current ways of doing things are not, in fact, inevitable, not only can they be questioned, they can be made better; they can changed in ways that are attentive to whom they benefit, are congruent with our current beliefs about best practice and may lead to the production of better doctors.

via Looking back to move forward: using history, disco… [Med Teach. 2013] – PubMed – NCBI.

MANUSCRIPT: General practitioners’ choices and their determinants when starting treatment for major depression: a cross sectional, randomized case-vignette survey.

BACKGROUND:
In developed countries, primary care physicians manage most patients with depression. Relatively few studies allow a comprehensive assessment of the decisions these doctors make in these cases and the factors associated with these decisions. We studied how general practitioners (GPs) manage the acute phase of a new episode of non-comorbid major depression (MD) and the factors associated with their decisions.
METHODOLOGY/PRINCIPAL FINDINGS:
In this cross-sectional telephone survey, professional investigators interviewed an existing panel of randomly selected GPs (1249/1431, response rate: 87.3%). We used case-vignettes about new MD episodes in 8 versions differing by patient gender and socioeconomic status (blue/white collar) and disease intensity (mild/severe). GPs were randomized to receive one of these 8 versions. Overall, 82.6% chose pharmacotherapy; among them GPs chose either an antidepressant (79.8%) or an anxiolytic/hypnotic alone (18.5%). They rarely recommended referral for psychotherapy alone, regardless of severity, but 38.2% chose it in combination with pharmacotherapy. Antidepressant prescription was associated with severity of depression (OR = 1.74; 95%CI = 1.33-2.27), patient gender (female, OR = 0.75; 95%CI = 0.58-0.98), GP personal characteristics (e.g. history of antidepressant treatment: OR = 2.31; 95%CI = 1.41-3.81) and GP belief that antidepressants are overprescribed in France (OR = 0.63; 95%CI = 0.48-0.82). The combination of antidepressants and psychotherapy was associated with severity of depression (OR = 1.82; 95%CI = 1.31-2.52), patient’s white-collar status (OR = 1.58; 95%CI = 1.14-2.18), and GPs’ dissatisfaction with cooperation with mental health specialists (OR = 0.63; 95%CI = 0.45-0.89). These choices were not associated with either GPs’ professional characteristics or psychiatrist density in the GP’s practice areas.
CONCLUSIONS/SIGNIFICANCE:
GPs’ choices for treating severe MD complied with clinical guidelines better than those for mild MD; GPs rarely recommended psychotherapy alone but rather as a complement to pharmacotherapy. Their decisions were mainly influenced by personal life experience and attitudes regarding treatment more than by professional characteristics. These results call into question the methods and content of continuing medical education in France about MD management.

via General practitioners’ choices and their determinan… [PLoS One. 2012] – PubMed – NCBI.